Individual provider Active NPI

Taelor Deann Johnson, SLP

  • Speech-Language Pathologist
  • Johnston, IA
National Provider Identifier
1487330072
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
118638 Issued in IA
Practice address
5530 West Pkwy Ste 300
Johnston, IA 50131-2258
Phone
(515) 419-4270
Fax
(319) 382-7822
NPI assigned
Jun 27, 2023
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 118638 IA Primary

Addresses

Primary practice location

5530 West Pkwy Ste 300
Johnston, IA 50131-2258

Mailing address

5530 West Pkwy Ste 300
Johnston, IA 50131-2258
Phone (515) 419-4270

Other practice location 1

2001 Westown Pkwy Ste 104
West Des Moines, IA 50265-1540
Phone (515) 223-9625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231017002370 IA Practitioner - Qualified Speech Language Pathologist 6608221262 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabvisions Therapy NE, LLC Speech-Language Pathologist CurrentSince Sep 9, 2023 Accepting new patients
Rehabvisions Therapy NE, LLC Speech-Language Pathologist CurrentSince Sep 9, 2023 Accepting new patients

Locations

2001 Westown Pkwy
Ste 104
West Des Moines, IA 50265
Phone (402) 334-6063

11623 Arbor St
Ste 200
Omaha, NE 68144
Phone (402) 334-1919

11623 Arbor St
Omaha, NE 68144
Phone (402) 334-1919

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1487330072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 WEST PKWY STE 300",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312258",
            "telephone_number": "515-419-4270",
            "fax_number": "319-382-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 WEST PKWY STE 300",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312258",
            "telephone_number": "515-419-4270",
            "fax_number": "319-382-7822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Westown Pkwy Ste 104",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "502651540",
            "country_code": "US",
            "telephone_number": "515-223-9625",
            "fax_number": "402-334-6063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAELOR",
        "middle_name": "DEANN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "118638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.